Gestational Diabetes and Postpartum Care

Information for Pregnant Individuals with Gestational Diabetes Mellitus

What is gestational diabetes mellitus?

Gestational Diabetes Mellitus (also known as GDM or Gestational Diabetes) is a type of diabetes that develops during pregnancy. Gestational means "in pregnancy". Diabetes means having more sugar (glucose) in your blood than your body needs or uses. For most individuals, gestational diabetes begins during the second trimester. In 2018, gestational diabetes or preexisting diabetes was a complication for 11.4 percent of pregnant individuals who gave birth in a California hospital. This number is higher among certain ethnic groups such as African American, Asian American and Pacific Islander, East Indian, Latino/Hispanic and Native American¹.

If you have gestational diabetes, your blood sugar is elevated from of the foods you eat, beverages you drink, and pregnancy hormones. With diabetes, either the body does not make enough insulin (Type 1 diabetes), or the body is not able to use insulin appropriately and causes blood sugar to rise above normal (Type 2 diabetes). The difference between Type 1, Type 2 and gestational diabetes is gestational diabetes is not likely to cause birth defects.

How is gestational diabetes diagnosed?

 

All pregnant individuals should be tested for GDM. This test is called a glucose loading test. If you are at risk for developing gestational diabetes, you should be tested during your first prenatal visit. If your initial test results are normal, there is a second screening test at 24-28 weeks of pregnancy.

How is gestational diabetes treated?

The treatment for gestational diabetes includes:

• choosing the right foods to eat
• gaining the recommended amount of weight during pregnancy
• eating at the right time
• exercising safely and regularly
• keeping your blood sugar levels normal
• testing and recording your blood sugar levels

A registered dietitian/nutritionist (RD/RDN) will help you create a meal plan that provides good nutrition and helps you control your blood sugar. Some individuals need to take oral medication or inject insulin to keep their blood sugar within normal limits. It is important to go to all your doctor's and health care team visits. These visits are where you can ask questions and learn about gestational diabetes.

What can happen to me and my baby if my blood sugar levels aren't under control?

Blood sugar is used for energy by the body. Your body will only use what it needs. The blood sugar you do not use goes to your baby. If your baby receives too much sugar from you, the baby stores it as fat. For this reason, many individuals with gestational diabetes have very large babies. These babies are at risk for having a rapid drop in their blood sugar after birth. This is not healthy, and these babies may need to go to a special care nursery.

Large babies are also more difficult to deliver. This may cause birth injuries to both mom and baby. The baby's arm or shoulder could be broken during delivery. If your baby is too large, you can have vaginal (birth canal) injuries. To avoid birth injuries, some individuals will need a cesarean section (sometimes called a c-section). A cesarean section means the baby is delivered by surgery.

When your sugars are too high, it can make it hard for your baby to get food and oxygen which it needs for normal growth. Careful control of your blood sugar and weight gain during pregnancy can help you avoid the following complications for yourself and your baby:

• difficult delivery
• high blood pressure
• cesarean section (c-section)
• macrosomia (babies weighing more than 9 pounds at birth)
• newborn hypoglycemia (low blood sugar)
• birth injury to the arm or shoulder of baby
• jaundice (yellowing of the skin) of baby
• respiratory problems (breathing problems) of baby
• premature birth (baby born before 37 weeks of pregnancy)
• stillbirth (baby dies before birth)
  

Where can I get help to control my blood sugar levels?

Your health care provider will tell you when you should call if you have questions in between visits. The following resources may also be helpful. 

• NUPA MyPlate gives you guidelines for food choices and portion size.
• Sample Snacks gives you ideas for nutritious snack.
• Eating Out Wisely provides healthy choices for eating out.
  

• Exercise in Pregnancy guides your physical activities
  

Remember, this is general information, and it does not replace seeing a health care provider.

Reference

1. California Department of Health Care Access and Information, Patient Discharge Data, 2018.​